Provider Demographics
NPI:1205047271
Name:MORROW, KENNETH G (LCSW, LISW)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:G
Last Name:MORROW
Suffix:
Gender:M
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2807
Mailing Address - Country:US
Mailing Address - Phone:502-554-8583
Mailing Address - Fax:
Practice Address - Street 1:1382 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-2351
Practice Address - Country:US
Practice Address - Phone:502-637-4361
Practice Address - Fax:502-637-4490
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35121041C0700X
OHI.16006891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical